Signs and Symptoms of Perimenopause and Menopause

Menopause is a natural part of life for many people. It marks the end of the time when a person can get pregnant. This change does not happen all at once. It is a journey that often begins years before the final period. Understanding the signs of perimenopause and menopause can help you feel more in control.¹

What is perimenopause?

Perimenopause is the time leading up to menopause. During this stage, the body starts to make less of the hormones estrogen and progesterone. Most people start perimenopause in their 40s. Some may notice changes even earlier.²

You are in perimenopause when your periods start to change. They may become longer or shorter. The flow might be heavier or lighter than usual. You might even skip a few months. These changes happen because your body is preparing for a new phase.²

What are the common symptoms of the transition?

As hormone levels go up and down, they cause a variety of symptoms. Every person has a different experience. Some people have many symptoms. Others may have very few. The intensity of symptoms can also vary from person to person.^1-4

Common symptoms of perimenopause include:^1-4

• Hot flashes - This is often the most common symptom. A hot flash is a sudden feeling of warmth that travels through the body. They can last for a few seconds or several minutes.
• Night sweats - These are hot flashes at night. They can interfere with sleep.
• Sleep problems (insomnia) – often caused by night sweats
• Mood changes – for example, increased irritability, depression, anxiety, or mood swings
• Brain fog – Difficulty focusing or remembering things, which can be worsened by insomnia
• Changes in sex drive (libido) – a reduced interest in sex
• Vaginal dryness – this can lead to pain during sex or burning with urination
• Urinary urgency – The need to pee more frequently
• Urinary incontinence - The loss of small amounts of urine

When is it officially menopause?

Menopause is a specific point in time. You reach menopause after you go 12 months in a row without a period. After this point, you are in postmenopause.¹

The symptoms from perimenopause may continue for a while – typically several years. But over time, symptoms usually begin to fade. It is important to track your cycle. This helps you know when you have reached this milestone and when to talk to your doctor about unexpected bleeding.¹

How do symptoms affect the body?

These changes affect more than just your menstrual cycle. Lower estrogen can lead to other physical shifts, such as:^1-4

• Skin and hair changes – Skin may become thinner or drier. Hair might thin out on the head.
• Reduced bone mass – Bones can become weaker over time. This is called bone loss (osteoporosis).
• Weight gain – Hormonal changes can slow metabolism and impact weight.
• Heart health – As estrogen drops, cholesterol can increase, increasing your risk of heart disease and stroke.
• Bladder issues – Estrogen keeps the tissue in the vagina healthy. Low levels of estrogen can weaken the vagina tissue, and so you may feel the need to pee more often or experience pelvic organ prolapse.
• Sexual health – You might experience low libido and vaginal dryness, which can make sex painful.

These are not all the ways that menopause can affect the body. Taking care of your physical and mental health and well-being – like eating well and staying active – is vital during this time. Lifestyle changes like keeping your house cooler or improving sleep habits may also be very helpful.

Talk to your doctor

You do not have to manage these changes alone. If symptoms bother you, talk to a healthcare professional. They can suggest treatment options to find relief.

Before your visit, write down your symptoms and any questions that you have. Note when they happen and how they feel. Tell your doctor about any other health conditions. Also, list any vitamins or supplements you take. Your doctor can help create a plan that works for you.